Antibody responses to the SARS‐CoV‐2 vaccines in hemodialysis patients: Is inactivated vaccine effective?

Abstract

Introduction Vaccines generally have reduced effectiveness in hemodialysis patients and a similar condition may also apply for the SARS‐CoV‐2 vaccines. The aim of this study was to analyze humoral responses of hemodialysis patients to SARS‐CoV‐2 vaccines. Methods Eighty‐five maintenance hemodialysis patients who received either inactivated or mRNA SARS‐CoV‐2 vaccines were investigated. Antibody levels were measured by a commercial antibody kit, which detected antibodies toward receptor binding domain of the SARS‐CoV‐2 spike protein. Comparative analyzes were carried between vaccine groups and with a control group of 103 healthy volunteers. Results Seropositivity rate and antibody levels were significantly lower in hemodialysis patients who received inactivated vaccine ( p = 0.000). While mRNA vaccine had better immunogenicity, both vaccines protected from symptomatic infection when seropositivity was achieved. Discussion/Conclusion When used in the same dose with the general population, inactivated SARS‐CoV‐2 vaccines generate reduced humoral response in hemodialysis patients. mRNA vaccines have better immunogenicity in this group.

Immunogenicity of COVID‐19 vaccines in patients with diverse health conditions: A comprehensive systematic review

“…Seropositivity of COVID‐19 among dialysis recipients is reported in Figure 5 and Supporting Information: Supplement . Two studies were included, and Pfizer, Moderna, and CoronaVac vaccines were used in the studies 21,32 …”

“…However, according to one study, when comparing whether there were side effects, inactivated vaccine showed fewer side effects. It may be due to a higher immune response through the mRNA vaccine 32 …”

Short and mid‐term SARS‐CoV‐2 antibody response after inactivated COVID‐19 vaccine in hemodialysis and kidney transplant patients

“…17 With respect to inactivated vaccines; anti-spike immunoglobulin G (IgG) antibody response was detected in more than 80% of dialysis patients, but lower than 20% of kidney recipients after two doses of CoronaVac vaccines. [18][19][20] These results reflect an 8-week time course and lead to debates about antibody response and its protection in RRT patients in the long term. In addition, detailed physical examination and biochemical parameters such as complete urinalysis, hemogram, liver, and kidney function tests were examined before serum collection and before each vaccination.…”

“…However, both vaccines could be protected from symptomatic COVID‐19 disease when seropositivity was achieved. 19 In another study, IgG antibody response after two doses of inactivated vaccine administered to HD and peritoneal dialysis patients was 88%, whereas it was 100% in the healthy group. The results of whether antibody titers remained high after the 2‐month period were not reported.…”

“…In a study on HD patients, the seroconversion rates (80%) and neutralizing antibody levels (median 39.8 BAU/ml) were significantly lower in patients who received inactivated vaccines, whereas mRNA vaccines had better immunogenicity. However, both vaccines could be protected from symptomatic COVID‐19 disease when seropositivity was achieved 19 . In another study, IgG antibody response after two doses of inactivated vaccine administered to HD and peritoneal dialysis patients was 88%, whereas it was 100% in the healthy group.…”